Figure 1t1b

Recurrence of Wegener's granulomatosis or microscopic polyangiitis has been reported after transplantation, with overall renal and extrarenal recurrence rates of up to 29% and renal recurrences alone of up to 16% [27]. Graft loss has been reported in up to 40% of patients with renal recurrence. In the most recent data from the Hammersmith Hospital, however, renal recurrences were rare, with only 0.018 relapses per patient per year after transplantation [26]. These patients have often been on long courses of immunosuppressive therapy before receiving a graft. Extrarenal recurrence of Wegener's granulomatosis can involve the ureter, causing stenosis and obstructive nephropathy. Serial monitoring of antineutrophil cytoplasmic antibodies after transplantation is important in all patients with vasculitis because changes in titer may predict disease relapse [28,29]. (Adapted from Allen and coworkers [26].)

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